‘Tattoo’ may help diabetics track their blood sugar

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People with type I diabetes must prick their fingers several times a day to test their blood sugar level. Though the pain is minor, the chore interferes with daily life.

“They never really escape it,” says Paul Barone, a postdoctoral researcher in MIT’s Department of Chemical Engineering. Barone and professor Michael Strano are working on a new type of blood glucose monitor that could not only eliminate the need for finger pricks but also offer more accurate readings.

“Diabetes is an enormous problem, global in scope, and despite decades of engineering advances, our ability to accurately measure glucose in the human body still remains quite primitive,” says Strano, the Charles and Hilda Roddey Associate Professor of Chemical Engineering. “It is a life-and-death issue for a growing number of people.”

Strano and Barone’s sensing system consists of a “tattoo” of nanoparticles designed to detect glucose, injected below the skin. A device similar to a wristwatch would be worn over the tattoo, displaying the patient’s glucose levels.

Continuous glucose detection

A 2008 study in the New England Journal of Medicine showed that continuous monitoring helped adult type I diabetes patients who were at least 25 years old better control their blood glucose levels. However, existing wearable devices are not as accurate as the finger-prick test and have to be recalibrated once or twice a day — a process that still involves pricking the finger.

“The most problematic consequences of diabetes result from relatively short excursions of a person’s blood sugar outside of the normal physiological range, following meals, for example,” says Strano. “If we can detect and prevent these excursions, we can go a long way toward reducing the devastating impact of this disease.”

Most existing continuous glucose sensors work via an injection of an enzyme called glucose oxidase, which breaks down glucose. An electrode placed on the skin interacts with a by-product of that reaction, hydrogen peroxide, allowing glucose levels to be indirectly measured. However, none of those sensors have been approved for use longer than seven days at a time.

Bruce Buckingham, a professor of pediatric endocrinology at the Stanford School of Medicine and an author of the NEJM study, says glucose monitoring is definitely headed toward wearable sensors. However, he expects it will be a few years before any are approved for use without backup monitoring with a finger prick test. “As time goes on, the devices to do this should become smaller, easier to wear, and more accurate,” says Buckingham, who is not involved in the MIT project.

Taking advantage of nanotubes

The technology behind the MIT sensor, described in a December 2009 issue of ACS Nano, is fundamentally different from existing sensors, says Strano. The sensor is based on carbon nanotubes wrapped in a polymer that is sensitive to glucose concentrations. When this sensor encounters glucose, the nanotubes fluoresce, which can be detected by shining near-infrared light on them. Measuring the amount of fluorescence reveals the concentration of glucose.

The researchers plan to create an “ink” of these nanoparticles suspended in a saline solution that could be injected under the skin like a tattoo. The “tattoo” would last for a specified length of time, probably six months, before needing to be refreshed.

To get glucose readings, the patient would wear a monitor that shines near-infrared light on the tattoo and detects the resulting fluorescence. One advantage of this type of sensor is that, unlike some fluorescent molecules, carbon nanotubes aren’t destroyed by light exposure. “You can shine the light as long as you want, and the intensity won’t change,” says Barone. Because of this, the sensor can give continuous readings.

Development of the nanoparticles and the wearable monitor is being funded by MIT’s Deshpande Center for Technological Innovation.

Barone and Strano are now working to improve the accuracy of their sensor. Any glucose monitor must pass a test known as the Clarke Error Grid, the gold standard for glucose-sensor accuracy. The test, which compares sensor results to results from a lab-based glucose meter, needs to be very stringent, since mistakes in glucose detection can be fatal.

They are still years away from human trials, says Barone, but they may soon start trials in animals. Those tests will be key to determining the value of this approach, says Buckingham. “You don’t know how good it will be until you put it in someone and see how strong the signal is,” he says.

Comments

John Allen

May 28, 2010

The fundamental challenge with this type of continuous monitoring is not the sensor which — on commercially available devices — are very accurate. The problem is with the fluid from which glucose is measured. The interstitial fluid that interacts with the sensor (as well as the proposed 'tattoo') does not accurately represent the glucose level in blood. This is due to the well-documented "lag" effect between the glucose level in blood compared to interstitial fluid. While continuous monitors like this do provide important and useful information, it will never pass the Clarke Error Grid standard when referenced to a blood-based measurement.

allen mendelson

June 1, 2010

I think this is a great approach in "wearable monitor". I guess in the future, everyone wear a sensor, and it senses the information of our body and sends to the control center.

Sebastián Carreras

June 1, 2010

I think that the levels of glucose in the several caps of skin is not that accurate than the direct blood measurement.

Good luck.

Naima Berouaken

June 1, 2010

Does this project take into consideration the risk on patient's health using nanotechnology.

Connie

June 2, 2010

Hello,

Kudos to you for your research and care! I would like to know if religion was considered during your quest for your glucose monitoring system. There are several religions that believe tattos are against what the Bible teaches, which is ,a tattoo is considered to be mutilating the body. What about the millions of people who wouldn't feel comfortable using your system for that reason? Thank You for your hard work, and I hope you succeed in creating a glucose monitoring system to help diabetics everywhere!

Can I bring to your attention that diabetics need a system that is easier,and more discreet, to use. You know the old phrase," less is best" I have diabetics in my family, and that is a major problem they have. My idea would be a small device, that through suction,pulls the blood to the surface of the skin, and a membrane attached that would instantly absorb the blood and give a reading....Anyway, have a great day, and keep creating!!

Jesse Lara

June 7, 2010

I would love to try this out instead of having to poke my finger everyday.

Suellen Sullivan

June 8, 2010

I also want to know where to sign up. Sticking my finger so many times a day is royal pain (literally).

If/when there is a research or test group, I would be willing to participate.

Joan V. Czarnowski-Hill

June 16, 2010

As the diabetes educator at MIT medical I've worked for over 20 years with People with Diabetes (PWD) that would jump at the chance to not have to check their glucose levels as we recommend. I'm delighted to see advances in technology. If and when you are in need of volunteers, you can reach out to me assuming I'm still here ... as I have lots of colleagues that would be interested too! Many diabetes educators are PWD too! Keep up the great work!

Marc Jarman

June 17, 2010

We studied nanotech CGM as the basis for an entrepreneurial business plan. Get the science and approvals right and:

1) Use it for type 2 diabetics (huge population)

2) And pre-diabetics

3) Monitoring in aged care facilities + aged care at home where 25% have diabetes

To help gain Doctor acceptance you may need to look at HA1c measurement too.

Godspeed

Marc Jarman

Craig Knox

June 22, 2010

Please excuse my ignorance... was wondering whether an infra red monitor similar to an oxygen pulse oximeter could be developed to measure glucose levels similar to how it measures oxygen levels in the blood ?

Frank Murgida

July 21, 2010

I've been a diabetic for 30 years and I don't believe finger pricking and monitoring is a real problem - it's just a bloody nuisance.

For the moment lets not let the diet and exercise mantra or the medical community influence the management of diabetes and consider only the glucose-sensing, insulin-determination (program), insulin injection cycle. In my opinion, this is the real problem, not blood glucose sensing. We diabetics must, faithfully, perform this cycle many time a day if we want to avoid the horror of long term diabetes that we have all observed in our friends and relatives. My message to the obviously passionate and dedicated authors of this article is to change your focus to an engineering solution to the whole diabetes management cycle not one small element of the problem. The medical community has spent billions of dollars over the last several decades trying to find a solution or cure with only minimal progress.

I don't believe it's really a viable product AS YET, but it's headed in the right direction.

HELP

Chris Hebert

July 21, 2010

I have had type 1 diabetes for the last 41 years and have been an insulin pump patient since 1990. Continuous glucose monitoring is necessary to spot trends in ones control. I currently use the medtronics continuous glucose monitoring system with my paradym insulin pump. The sensors are expensive, inaccurate, and painful to apply. I hope you will partner with Medtronics to offer a transmitter compatible with their insulin pumps. Keep up the good work!

Steven B. Southwick

July 26, 2010

I've had JOD for 36 yrs and initially benefitted from pumping, but gave it up due to dangerously erratic absorption of short-acting insulins, which is what pumps use for basals. I recently tried one of the CGMs and found it to be quite useful to show the start of rapid glucose drops. I think CGM can make a major contribution for some PWDs, and take great interest in this article. Thanks! Steve Southwick

Erin Carey

October 5, 2010

MIT wow what an awesome project. Making it fun to do something I have to do every day. I know the growing numbers of kids that have to suffer through this disease is catastrophic, being one of them I know. If you guys are doing any clinical trials I would love to be a part of this. PLEASE CONTACT ME!! erin.carey@me.com

Nicole Marien

October 13, 2010

Very happy to read that within a couple of years we can stop pricking our fingers (and I've only started in March 2008). Very discreet when dining in company. Will be perfect for glucose monitoring in the cockpit of my old timer aircraft, once EASA starts allowing insuline dependant pilots to get their license back. Cannot wait to get this.

Count me in if you need European test patients.

Donovan Shaw

November 2, 2010

if the tattoo fades what will happen? will it be refilled with new nanotech ink? and will the cost be affordable?

Dan Dascalescu

December 14, 2010

The University of Western Ontario has developed a contact lens that continuously alerts patients to variations in their glucose levels by changing colors - replacing the need to routinely draw blood throughout the day.

The technology uses extremely small nanoparticles embedded into the hydrogel lenses. These engineered nanoparticles react with glucose molecules found in tears, causing a chemical reaction that changes their color.

katie hawkes

January 20, 2011

My boyfirend is type 1 diabetic and has been going through a really bad time where he keeps having hypo's, the problem is that his blood glucose levels keep dropping extremely fast with no warning so taking finger prick tests do not always indicate if he is getting low. I would really like to know where i can get some of this tattoo ink so he has an indicator on if he is getting low and doesn't feel low. The constant fear of having to inject him to bring him round. It is really effecting his quality of life and i feel that having a tattoo that can tell him that he is low would give him some quality of life back. If anyone can help me, please leave me a message, i would greatly appreciate it, thank-you.

Buddy King

November 14, 2011

This development would be wonderful. I have been a Type One for sixty years. I am in pretty good shape, but sudden drops in blood sugar play havoc on my energy level. I saw one comment referring to a "CGM" which would alert a sudden glucose drop. I had a watch like device that helped while sleeping, but it no longer works. Does anybody know of any other alerts?

Robin Sherman-Witherow

April 8, 2013

Does anyone know what the current/updated status of this is? I just found out about it today. I've been a Type 1 diabetic since 1988 and am so! sick and tired of the finger pricking. It's gotten that I don't monitor the way I should because I don't want to test!

Lee Sun

July 12, 2013

I just found this today even though I've searched for similars many times before... I've been type 1 for 65 years and have been finger testing since meters first came out in the mid-70's. Lately, 'have been having way too many hypos, so this topic is really interesting and 'would like to know if any further progress has been made.

Lee

douglas parker

October 9, 2013

I have a 3 year son who has been a type 1 since 2012. I would love to here more about this. Updates and when human trails are ready...

Please contact me at kc5nqx@yahoo.com

Cyndi

July 1, 2014

I would love information on human trials as I have had type one for 28 years and in the last 12 years i no longer have signs of highs and lows I just pass out...